Sevelamer therapy for pediatric end-stage renal disease

Pharmacotherapy
Lara E StormsJames E Dice

Abstract

Sevelamer, a non-calcium-containing, non-aluminum-containing phosphate binder, is frequently prescribed for treatment in adults with hyperphosphatemia secondary to end-stage renal disease (ESRD). However, published information regarding sevelamer use in children younger than 11 years is lacking. We report the use of sevelamer as a phosphate binder in a 19-month-old girl with ESRD who was receiving calcium carbonate 1250 mg 3 times/day for hyperphosphatemia. The patient's initial serum phosphorus concentration was 8.6 mg/dl, and the calcium-phosphorus product was 75 mg(2)/dl(2). This was well above the level that places patients at risk for complications such as joint, vessel, and soft-tissue calcification. An aluminum-containing phosphate binder was not an option given the patient's renal disease and the concern for neurotoxicity. Sevelamer was considered, but a MEDLINE search revealed no pediatric dosing information. An initial dosage of 100 mg/kg/day divided every 8 hours was administered, as extrapolated from adult data, and then titrated to 130 mg/kg/day divided every 8 hours based on the patient's response. The child's dietary phosphorus intake remained constant throughout her hospital stay. During sevelamer therapy, her s...Continue Reading

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Citations

Oct 28, 2009·Journal of Feline Medicine and Surgery·Aimee C Kidder, Dennis Chew
Nov 26, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Denise BohrerElvino J G Barros
Dec 8, 2007·World Journal of Surgery·Katja SchlosserTheresia Weber
Mar 2, 2018·Journal of Pediatric Endocrinology & Metabolism : JPEM·Salma A Ajarmeh, Eyad M Al Tamimi
Jul 20, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S A H RizviZ Hussain
Jul 27, 2011·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Eleonora Moreira LimaUNKNOWN Sociedade Brasileira de Nefrologia

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